Can Sleep Apnea Cause Alzheimer’s?

journals that had me wondering: Could there be a link between Alzheimer’s Disease (AD) and obstructive sleep apnea?

The first study showed that people with OSA (see below) had a much higher incidence of silent lacunar infarcts on an MRI scan. Lacunar infarcts are very small areas of clotted small blood vessels in the brain. Essentially, these are microscopic strokes.

The second article showed that people with OSA had multiple areas of brain tissue that received significantly lesser amounts of blood flow. If a small vessel in your brain doesn’t get very much blood flow, then there’s a higher chance of clotting as well. A natural consequence of this process is that you’ll get scarring and changes that can overlap with findings that are seen in AD. Also, if you get less blood flow in your brain region, then you’ll have less neurotransmitter production and less need for glucose.

One of the hallmarks of (AD) is what’s found under the microscope during an autopsy. Two common findings of those with AD are neurofibrillary tangles (NFTs) and senile plaques (SPs). These are the scar tissue-like end-stage findings for many types of nerve damage. Although not specific to Alzheimer’s alone, NFTs and SPs are routinely stated as being one of the distinctive markers for this devastating condition. However, despite the millions or even possibly billions of dollars of research in this area, we still don’t know why this happens, what causes it or even how to prevent it.

As I was reading through these two articles, in conjunction with all the latest research about AD, I couldn’t help but to see a distinct merger between OSA and AD. This, in turn made me think about a short satirical video by a renowned osteopath Dr. Joseph Mercola and then all I could think about were skid marks on the side of the road.

The Skid Marks of Healthcare

This 10 minute video describes a town called Allopath. Due to budget cuts and an absence of stop signs at one especially busy intersection, the town experiences an alarming number of traffic accidents and injuries. As a result, a consultant with the Motor Division (MD) is brought in to diagnose the problem, and after careful analysis, he proclaims that the reason for all the traffic accidents is due to the presence of tire skid marks and his solution?: Cover up the deadly skid marks with teflon. Bolstered by the facts of this MD’s research the townspeople rally together to rid the town from offending skid marks. In doing so, new industries begin to crop up in their town. From a Teflon factory to ambulances and hospitals to car repair shops repairing the cars damaged by the increase in traffic accidents, the town’s economy booms. Yet, as the town’s economy grows, the rate of traffic accidents, rather than going down, inversely gets worse as the slick Teflon only causes more accidents. Eventually, the town’s economy crashes as many of the townspeople become disabled. In short, this video reveals a sad but true account of what’s happening with our health care system today.

Some of the cutting edge AD research in the prevention of worsening memory and cognitive functioning focuses on enhancing certain neurotransmitters and metabolic processes, such as acetylcholine or glucose. Drugs that lower enzymes or proteins that naturally degrade acetylcholine are shown to help with memory and cognition. Other research focuses on the biochemical and genetic properties of these NFTs and SPs, which are acknowledged to be the end-stage result of nerve damage and ultimate death. The reasoning is that by preventing NFTs and SP, we can prevent Alzheimer’s.

In so far as these very complex studies go, however, none has yet to explain how and why all these factors for AD interrelate. Until you consider, however, the possibility that Alzheimer’s may be one of many symptomatic end stages of obstructive sleep apnea (OSA).

OSA and AD: How Are they Alike?

Research reveals that people at risk for AD are also at risk for the routine cardiovascular conditions like high blood pressure, diabetes, and heart disease. Some researchers have stated that AD is a disease of the small vessels in the brain. Similarly, if you have OSA, you are more likely to have all of these heart problems, along with a higher likelihood to have strokes, or be obese. Another interesting symptom to note is that OSA promotes the kind of inflammation and clotting not unlike the kind of small blood clotting and neurotransmitter degeneration that’s commonly associated with those with Alzheimer’s.

With all these similarities between OSA and Alzheimer’s Disease, it’s not too far-fetched to consider them complimentary if not to see that one may be an aggravating factor for the other. There’s even evidence of a common gene linking AD with OSA.

Yet, even with all these studies showing strong correlations between OSA and AD, 80-90% of people with OSA are still not diagnosed in this country, and if my hypothesis is right this number probably includes many patients who are “at risk” for Alzheimer’s (i.e. family history, evidence of memory loss etc.) In fact, if would be even more important to screen for OSA when you are much younger, before neurologic impairment, heart disease, or more importantly, before Alzheimer’s sets in. In all of these scenarios, the time and money required in screening these potential patients for OSA would be miniscule compared to the rewards of preventing Alzheimer’s for even a small proportion of this population.

We Can Learn A Lot From a Dummy

As Mercola’s cartoon video showed, much of what we believe about scientific research is grounded in the premise that if it’s not too complex, it can’t be scientific. Even in the case of Alzheimer’s research and studies of OSA, much of the research is focused on what you can do after the disease has already set in. It may be that prevention methods, like eating right, exercising and sleeping well, seem too simple of a cure for such a complex problem like AD.

I don’t mean to offend all the good-intentioned doctors and researchers working on a “cure” for AD. Granted, eventually, there will be many drugs out there to slow the progression of AD, just like all the medications that we have for high blood pressure and heart disease. But could it be that by allowing these drugs to be so freely dispensed after the onset of disease, we’re providing a false sense of security for those “at risk” patients who may have otherwise put more effort into maintaing a healthier lifestyle?

Similarly, by just covering up the tire skid marks, rather than installing stop signs at that dangerous intersection, the town of Allopath thought they could “cure” traffic accidents. Of course, neither are fail safe measures for traffic accidents. Although not as sophisticated as Teflon,however, stop signs would have at least forced the citizens of Allopath to become more responsible drivers. Teflon just made the problem spiral out of control.

So the next time you hear screeching tires, stop to note the skid marks. Better yet, opt for prevention rather than easy cures. Moreover, if you have a history of AD in your family, and have noticed lately that you’re exhibiting signs of chronic fatigue or impaired memory or are experiencing classic symptoms of OSA, get a sleep study (to get a listing of sleep study centers in your area visit: ). Since AD is not (yet) currently reversible, it’s important to become proactive in preventing anything that can cause or aggravate it while you’re young to prevent any future brain injury.

5 thoughts on “Can Sleep Apnea Cause Alzheimer’s?”

Finally!!
I have been asking the medical staff at all the facilities I’ve worked to what the connection between the Alzheimer’s and sleep apnea. I’ve noticed that my patients with AD would actually have 30sec or more periods of apnea.
Please research this even further.

Hello, mr. Park,
Thank you so much,.. for your fast reaction. I will study this one…
Now i had time to watch your video too. Your talking about treatment of the soft palate…
What do you think about daily 6/8 hours “mouth breathing” while sleeping? I thought its more healthy to breath through the nose? is not?
thanks, Anton

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The Breathe Better, Sleep Better Live Better podcast is aimed at helping you get the sleep you need and the life you want. Hear from leading experts in the field of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) what you can do to overcome these chronic health problems.

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Dr. Steven Y. Park is an author and surgeon who helps people who are always sick or tired to once again reclaim their health and energy. For the past 13 years in private practice and 4 years in academia, he has helped thousands of men and women breathe better, sleep better, and live more fulfilling lives.

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